Screening of infants and young children with hyperbilirubinemia for sensorineural hearing impairment: an institutional study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20240662Keywords:
Hyperbilirubinemia, OAE, BERA, Acute bilirubin encephalopathy, Neonatal jaundice, Direct venous exchange transfusionAbstract
Background: Jaundice is one of the most common problems occurring in newborns. Severe neonatal hyperbilirubinemia is a common cause of sensory neural hearing loss. It is important to identify and treat the jaundice early, to prevent complications like encephalopathy leading to hearing loss. Early detection of hearing loss is important for early intervention. The aim of the study was to evaluate the prevalence of sensorineural hearing loss (SNHL) in children with hyperbilirubinemia and to correlate the degree of hearing loss with degree of hyperbilirubinemia.
Methods: The 50 cases including newborn and young children (<12 years of age) having history of hyperbilirubinemia and exchange transfusion were included in this study. After the approval and clearance from institutional ethical committee, this study was conducted from April 2021 to March 2022 in the department of ENT, govt. medical college Amritsar in co-ordination with department of pediatrics.
Results: On comparing brain stem evoked response audiometry (BERA) and otoacoustic emissions (OAE) results, it was found that out of 50 patients BERA was abnormal in 8 patients while 42 had normal BERA. 18% (9) patients had abnormal OAE results out of which 7 had bilateral REFER result while 2 had unilateral REFER result. On comparing the OAE and BERA for sensitivity and specificity, the sensitivity was 92.9% in right ear while specificity was 62.5%, whereas in left ear sensitivity was 95.2% while specificity was 75%.
Conclusions: According to our study the prevalence of sensorineural hearing impairment comes out to be 16% as per BERA. BERA is more sensitive and specific as compared to OAE. But still OAE can be used as screening test considering the cost factor and ease of conducting OAE test while BERA is a confirmatory test for SNHL.
References
Alexander TH, Harris JP. Incidence of sudden sensorineural hearing loss. Otol Neurotol. 2013;34(9):1586-9.
National Programme for the Prevention and Control of Deafness (NPPCD): National Health Mission. Available at: https://nhm.gov.in/index1.php?lang=1&level=2&sublinkid=1051&lid=606. Accessed on 12 January, 2024.
Sensorineural Hearing Loss. Boston Children Hospital. Available at: https://www.childrenshospital.org/conditions/sensorineural-hearing-loss. Accessed on 12 January, 2024.
Saluja S, Agarwal A, Kler N, Amin S. Auditory Neuropathy Spectrum Disorder in Late Preterm and Term Infants with Severe Jaundice. Int J Pediatr Otorhinolaryngol. 2010;74(11):1292-7.
BERA and OAE. en1neuro. Available at: https://www.en1neuro.com/services/bera-oae. Accessed on 12 January, 2024.
Porter ML, Dennis BL. Hyperbilirubinemia in the Term Newborn. AFP. 2002;65(4):599-607.
Kaplan M, Beutler E, Vreman HJ, Hammerman C, Levy-Lahad E, Renbaum P et al. Neonatal hyperbilirubinemia in glucose-6- phosphate dehydrogenase-deficient heterozygotes. Pediatrics. 1999;104(1):68-74.
Baradaranfar MH, Atighechi S, Dadgarnia MH, Jafari R, Karimi G, Mollasadeghi A et al. Hearing status in neonatal hyperbilirubinemia by auditory brain stem evoked response and transient evoked otoacoustic emission. Acta Med Iran. 2011;49(2):109-12.
Mirajkar S, Rajadhyaksha S. Hearing Evaluation of Neonates with Hyperbilirubinemia by Otoacoustic Emissions and Brain Stem Evoked Response Audiometry. J Nepal Paediatr Society. 2017;36:310.
Wickremasinghe AC, Risley RJ, Kuzniewicz MW, Wu YW, Walsh EM, Wi S et al. Risk of Sensorineural Hearing Loss and Bilirubin Exchange Transfusion Thresholds. Pediatrics. 2015;136(3):505-1.
Ullah S, Rahman K, Hedayati M. Hyperbilirubinemia in Neonates: Types, Causes, Clinical Examinations, Preventive Measures and Treatments: A Narrative Review Article. Iran J Public Health. 2016;45(5):558-68.
Bhatt J, Kuchhal V, Saklani K, Kumar V. Accuracy of OAE and BERA to detect the incidence of hearing loss in newborn. J Evolution Med Dental Sci. 2015;4:8466-74.
